See this PJTV video on Obama's czars.
This wouldn't be funny even if it were a sitcom. But having this many people (almost three dozen) in "charge" of so much of our country - health, drugs, terrorism, information technology, automobiles, science, etc. - when none of them are elected officials accountable to the citizens...it's just a tad scary.
Also...really? Can you not come up with a less communist/imperialist word than "czar"?
Showing posts with label nationalization. Show all posts
Showing posts with label nationalization. Show all posts
Saturday, August 22, 2009
Thursday, June 25, 2009
Health Care, again
Universal Health Care. Sounds like a noble undertaking, yes? Health care is a constitutionally mandated "right" for every American. Wonderful.
A Umiversity of Minnesota professor and expert on health care economics testified before the House subcommittee on health Tuesday, and here's the summary of his research:
So, let's do a little bit of math here.
In 2010, there Census estimates there will be about 310.2 million people in the US. By 2020 (let's call that the end of the 10 year period), Census estimates about 341.4 million people.
According the Census data, the US averages about 2.6 people per household. I want to use Households as the relevant statistic, because most of us live in two income families, or at least the insurance we pay for covers a family and not just a single person.
So, extrapolating on the 2.6 people per household, let's say that in 2010 there will be somewhere north of 119.3 million households and in 2020 there will be about 131.3 million.
Let's take the $4 Trillion number, so we make sure and cover all of the presently uninsured, which is, of course, the goal of Universal Health Care.
We'll assume (simplistically, for the sake of the math) that the $4T will be spread evenly over the 10 year period. That equals $400B/yr.
Divide $400B by the number of households and you get this:
2010: $400B / 119.3M = $3352/household
2020: $400B / 131.3M = $3046/household
That number you're looking at is the amount of additional tax burden per household. The number obviously drops slightly each of the 10 years because the population grows but we're assuming the annual expenditure on health care remains constant. Note that in reality, this will not be the case. In actual fact, the initial (start-up) costs will be high for a few years, then presumably drop somewhat, but continue to rise indefinitely over time (via inflation, if nothing else, but there are many other factors that will cause cost increases).
But again for simplicity, let's stick with the numbers as figured. For comparison sake, I pay premiums to my company's HMO plan of $3480/yr. For an apples to apples comparison (tax increase vs. current premiums paid), it's a net decrease in my out of pocket cost since presumably my deductibles/coinsurance/etc would be comparable. Great!
Or...is it great? What benefit do I get from the $3352 increase in my tax bill?
That's a great questions, Chris, I'm glad you asked.
Again per the good Doctor from Minnesota:
So. "Medium levels of generosity" = no better than average health care provided. "Average level of access" to doctors. "Manageable copays". A 15% coinsurance rate (mine is 10%, btw). So essentially no better service than what I'm getting now, for roughly the same out of pocket. Yet the health providers are getting 10% less than they do now. If you were asked to do the same job you do now, but take a 10% pay cut, how long do you think you'd stick around in that job? Now do you see why Great Britain has a shortage of doctors (especially specialists)? Oh yeah, one more thing: the 10% above Medicare reimbursement amount? That's not set in stone - that's just the initial amount. Anyone else want to bet that as costs rise (and they will), the first thing Your Government Health Insurer will do is reduce payout rates to providers? Fewer doctors available means that "average level of access" becomes a "poor level of access" over time.
So if I personally am not getting a better deal with my shiny new Gov't Health Care Plan, surely the uninsured are getting help! Those poor people! That was a stated goal of Universal Health Care, was it not?
Assume each year for the 10 year period, 1/10 of those uninsured now are on the Gov't Plan. How many people is that? Well, the Hoover Institute says: 11% of the population are considered Long Term Uninsured (they don't get coverage for at least a full year). In 2010, that's just over 34 million folks. But wait, there's more! The Kaiser Foundation says: 19% of the uninsured can afford it but don't pay for it. 25% of the uninsured are eligible for some current program (employer provided, SCHIP, medicaid, etc) but don't enroll. So that leaves 56% of the uninsured for whom affordability is an issue. 56% of 34 million people is a little over 19 million. If you want to take out the illegal immigrants who are sucking up health care resources but can't pay for them, you drop from 19 million to 15 million or so. But we'll leave it at 19 million just for the sake of argument.
19 million people uninsured who can't afford to get insurance. 1/10 of that would be 1.9 million people that we can move each year onto the government teat. $400 Billion divided by 1.9 Million equals roughly $210,500 per uninsured.
Put it another way: We are proposing spending $400,000,000,000 per year for the next 10 years to move one-half of one percent of the American population per year from uninsured status onto a (marginally useful, massively wasteful) insurance plan. The rest of us that currently have insurance or can afford it also get put onto this insurance plan that provides a low-to-average level of care, massive governmental intrusion into our personal choices, and the inability to opt out into anything better.
Now does it seem like you're getting your (tax) money's worth? Is this really the best way to go, just so we can say "hey! everyone's covered now!"?
A Umiversity of Minnesota professor and expert on health care economics testified before the House subcommittee on health Tuesday, and here's the summary of his research:
To achieve a 30% net reduction of the uninsured, it will cost taxpayers about $1.3 Trillion over the next 10 years.
To achieve a 70% net reduction of the uninsured, it will cost taxpayers about $2.7 Trillion over the next 10 years.
To achieve a 100% net reduction of the uninsured, it will cost taxpayers about $4 Trillion over the next 10 years.
So, let's do a little bit of math here.
In 2010, there Census estimates there will be about 310.2 million people in the US. By 2020 (let's call that the end of the 10 year period), Census estimates about 341.4 million people.
According the Census data, the US averages about 2.6 people per household. I want to use Households as the relevant statistic, because most of us live in two income families, or at least the insurance we pay for covers a family and not just a single person.
So, extrapolating on the 2.6 people per household, let's say that in 2010 there will be somewhere north of 119.3 million households and in 2020 there will be about 131.3 million.
Let's take the $4 Trillion number, so we make sure and cover all of the presently uninsured, which is, of course, the goal of Universal Health Care.
We'll assume (simplistically, for the sake of the math) that the $4T will be spread evenly over the 10 year period. That equals $400B/yr.
Divide $400B by the number of households and you get this:
2010: $400B / 119.3M = $3352/household
2020: $400B / 131.3M = $3046/household
That number you're looking at is the amount of additional tax burden per household. The number obviously drops slightly each of the 10 years because the population grows but we're assuming the annual expenditure on health care remains constant. Note that in reality, this will not be the case. In actual fact, the initial (start-up) costs will be high for a few years, then presumably drop somewhat, but continue to rise indefinitely over time (via inflation, if nothing else, but there are many other factors that will cause cost increases).
But again for simplicity, let's stick with the numbers as figured. For comparison sake, I pay premiums to my company's HMO plan of $3480/yr. For an apples to apples comparison (tax increase vs. current premiums paid), it's a net decrease in my out of pocket cost since presumably my deductibles/coinsurance/etc would be comparable. Great!
Or...is it great? What benefit do I get from the $3352 increase in my tax bill?
That's a great questions, Chris, I'm glad you asked.
Again per the good Doctor from Minnesota:
That 4 trillion estimate over 10 years assumes a public option plan with Bronze, Silver and Gold levels in the proposed insurance exchange with a subsidy for premium support that is income-adjusted and calibrated for assistance at the Silver level. The Silver level is equivalent of PPO plan with medium levels of generosity, something with 15% coinsurance rate, manageable copays and average level of access to physicians and hospitals. We accounted for the public plan being reimbursed at 10% above Medicare reimbursement, which is also 10% below commercial insurance premiums.
So. "Medium levels of generosity" = no better than average health care provided. "Average level of access" to doctors. "Manageable copays". A 15% coinsurance rate (mine is 10%, btw). So essentially no better service than what I'm getting now, for roughly the same out of pocket. Yet the health providers are getting 10% less than they do now. If you were asked to do the same job you do now, but take a 10% pay cut, how long do you think you'd stick around in that job? Now do you see why Great Britain has a shortage of doctors (especially specialists)? Oh yeah, one more thing: the 10% above Medicare reimbursement amount? That's not set in stone - that's just the initial amount. Anyone else want to bet that as costs rise (and they will), the first thing Your Government Health Insurer will do is reduce payout rates to providers? Fewer doctors available means that "average level of access" becomes a "poor level of access" over time.
So if I personally am not getting a better deal with my shiny new Gov't Health Care Plan, surely the uninsured are getting help! Those poor people! That was a stated goal of Universal Health Care, was it not?
Assume each year for the 10 year period, 1/10 of those uninsured now are on the Gov't Plan. How many people is that? Well, the Hoover Institute says: 11% of the population are considered Long Term Uninsured (they don't get coverage for at least a full year). In 2010, that's just over 34 million folks. But wait, there's more! The Kaiser Foundation says: 19% of the uninsured can afford it but don't pay for it. 25% of the uninsured are eligible for some current program (employer provided, SCHIP, medicaid, etc) but don't enroll. So that leaves 56% of the uninsured for whom affordability is an issue. 56% of 34 million people is a little over 19 million. If you want to take out the illegal immigrants who are sucking up health care resources but can't pay for them, you drop from 19 million to 15 million or so. But we'll leave it at 19 million just for the sake of argument.
19 million people uninsured who can't afford to get insurance. 1/10 of that would be 1.9 million people that we can move each year onto the government teat. $400 Billion divided by 1.9 Million equals roughly $210,500 per uninsured.
Put it another way: We are proposing spending $400,000,000,000 per year for the next 10 years to move one-half of one percent of the American population per year from uninsured status onto a (marginally useful, massively wasteful) insurance plan. The rest of us that currently have insurance or can afford it also get put onto this insurance plan that provides a low-to-average level of care, massive governmental intrusion into our personal choices, and the inability to opt out into anything better.
Now does it seem like you're getting your (tax) money's worth? Is this really the best way to go, just so we can say "hey! everyone's covered now!"?
Tuesday, May 12, 2009
Is this really a surprise to anyone?
Hate to say I told you so, but I told you so. Not that that's any consolation.
Here we have yet another proponent of nationalized health care taking the single-payer health care system's cost/benefit analysis to its logical conclusion. To wit: the elderly won't be around long enough to repay the system for the inordinate amount of resources expended on extending their lives. Therefore, NO SOUP FOR YOU.
Where is the AARP on this issue? I thought Boomers, et al were supposed to be the greatest voting bloc ever! Why is there no outrage about this? Because it's too hard to imagine? Is it willful blindness? Because it's too many years down the road? Just because someone says NOW "no, that's not going to happen" doesn't mean it won't happen AT SOME POINT. It's the logical conclusion.
A side question: it's almost a given that medical tourism will rise if/when this happens. But what's the chances a parallel "underground" health system will arise in America? A "black market" in health care, so to speak - and I'm not talking about alternative medicines and marijuana here. I have no idea. The thought just occurred to me.
Here we have yet another proponent of nationalized health care taking the single-payer health care system's cost/benefit analysis to its logical conclusion. To wit: the elderly won't be around long enough to repay the system for the inordinate amount of resources expended on extending their lives. Therefore, NO SOUP FOR YOU.
Where is the AARP on this issue? I thought Boomers, et al were supposed to be the greatest voting bloc ever! Why is there no outrage about this? Because it's too hard to imagine? Is it willful blindness? Because it's too many years down the road? Just because someone says NOW "no, that's not going to happen" doesn't mean it won't happen AT SOME POINT. It's the logical conclusion.
A side question: it's almost a given that medical tourism will rise if/when this happens. But what's the chances a parallel "underground" health system will arise in America? A "black market" in health care, so to speak - and I'm not talking about alternative medicines and marijuana here. I have no idea. The thought just occurred to me.
Thursday, May 07, 2009
The Only Choice
Link-heavy post over at Protein Wisdom on the coming nationalization (bastardization is a better word) of the American health care system. We've already talked here about the nationalized systems of Canada, Britain, and France, and how nationalization leads to rationing, which leads to picking winners (young and healthy taxpayers) and losers (the elderly and chronically ill). No one wants to admit this is going to happen. And, as always, it's marketed by Dems and others as "a moral right to quality health care" with bunnies and flowers and unicorns!
I was having a conversation with someone this past weekend. We were discussing the powers of the federal government vs. state and local governments. He said he thought state and local governments had too much power (speaking specifically of high property taxes and eminent domain laws). I said, at least you can leave a city or state if you don't like the way things are run. It's infinitely harder to leave the United State of America if you don't like the way it's being run.
You just have to deal with it, you try to change people's opinions, you try to get your guy voted in next time.
I used to want to live in Australia or Britain someday, but they are both further along the nanny-state path than we are - although we're running hard to catch up.
I was having a conversation with someone this past weekend. We were discussing the powers of the federal government vs. state and local governments. He said he thought state and local governments had too much power (speaking specifically of high property taxes and eminent domain laws). I said, at least you can leave a city or state if you don't like the way things are run. It's infinitely harder to leave the United State of America if you don't like the way it's being run.
You just have to deal with it, you try to change people's opinions, you try to get your guy voted in next time.
I used to want to live in Australia or Britain someday, but they are both further along the nanny-state path than we are - although we're running hard to catch up.
Friday, April 17, 2009
You have got to be kidding me
1) Financial crisis occurs. Myriad, sundry reasons.
2) Reduce myriad, sundry reasons down to one: banks did Bad Stuff and are now undercapitalized.
3) Ergo, to reduce the damage to the American economy and reverse the Bad Stuff, give TARP cover to banks, ostensibly so banks can become profitable.
3a) TARP cover has strings attached, natch.
4) Demagogue that bank-caused financial crisis led to auto maker crisis.
5) Force banks to write off very significant loans now in default by auto makers.
Hm. Force banks into unprofitable banks further into unprofitability to save unprofitable auto makers.
See the logic here?
2) Reduce myriad, sundry reasons down to one: banks did Bad Stuff and are now undercapitalized.
3) Ergo, to reduce the damage to the American economy and reverse the Bad Stuff, give TARP cover to banks, ostensibly so banks can become profitable.
3a) TARP cover has strings attached, natch.
4) Demagogue that bank-caused financial crisis led to auto maker crisis.
5) Force banks to write off very significant loans now in default by auto makers.
Hm. Force banks into unprofitable banks further into unprofitability to save unprofitable auto makers.
See the logic here?
Wednesday, April 08, 2009
A funny story about the advent of nationalized health care
Let's say you've got a massive organization (we'll call it "government", just for kicks) which has a monopoly on the health care providers and payment system of a particular country (which we'll call "America").
Now suppose you are in charge of running said health care monopoly. Now you got a degree in business from a prestigious school and you remember your professors saying the way to make a business grow is to exercise good financial management: to wit, hold down costs and increase revenue.
Increasing revenue is easy. Since the same "government" that runs the health care monopoly is the one that can raise taxes, just raise taxes and designate a portion of those taxes (less government employee salaries, kickbacks, bribes, and other related costs) to fund the health care monopoly. (For the sake of this argument, we'll assume that you went to an Ivy League business school where your professors didn't teach the Laffer Curve, the Austrian School of Economics, free-market capitalism, von Mises, Hayek, or Friedman. Plus, you work in an Administration that eschews such economic drivel, preferring to pursue an Agenda, and economics be damned.)
So. If you were going to hold down costs related to health care, you'd look at two places - the health care providers and the health care recipients. Now in an actual competitive business environment, you can't consider the health care recipients as a "cost", since they are the consumers - the source of revenue. But in a health care monopoly run by "government", health care recipients are a cost driver, not a revenue source. How do you lower costs associated with health care recipients? Easy: You want them to be healthy; you don't want them using the health care services. In a health care monopoly, how do you accomplish that? Two potential ways.
1) Raise the price of items, services, and activities that you deem "health-averse". Or mandate against (i.e. ban) items, services, and activities that you deem "health-averse". This would be anything from fast food (too fattening, leads to obesity, increasing the need for health care) to motorcycles (too dangerous, no seatbelts, higher incidence of accidents, increasing the need for health care) Since the health care monopoly is run by the same "government" that can pass laws banning such items (or heavily taxing "health-averse" items, services, and activities, making them so expensive as to essentially remove the consumer market for same), this course of action should be of primary importance. All you need to do is make a list of characteristics exhibited by habitual health-care users, then make a list of items, services, and activities that contribute (in one form or other) to said characteristics. Ban or heavily tax such items. Which leads to the second way to lower costs related to health care recipients...
2) Note that elderly adults are disproportionately disposed to need health care, and at a typically higher-level (read: more costly) version of health care than their less-senior counterparts. Ergo, advanced aging is bad, and should be discouraged. Since outright murder of elderly citizens is not politically efficient, in practical terms "discouraging aging" means withholding (or making so costly as to effectively prevent the use of) health care for certain "high-risk" health care recipients, the elderly being among those considered "high-risk". Also, diabetics, AIDS patients, and preemie (the so-called "Million Dollar") babies.
To summarize: a health care monopoly run by "government" is one predisposed to pick winners and losers (those who can receive a modicum of health care, and those who cannot, respectively). Winners being young, healthy, wealthy, and/or risk-averse citizens. Losers being elderly, chronically ill, low-to-moderate income, and/or thrill-seeking citizens.
A modest proposal? A brave new world? No. Look no further than the first paragraph of this AP article:
Not such a funny story is it?
UPDATE:
Heh. Hannity and British MEP Daniel Hannan discuss the topic. The Brit knows whereof he speaks.
Now suppose you are in charge of running said health care monopoly. Now you got a degree in business from a prestigious school and you remember your professors saying the way to make a business grow is to exercise good financial management: to wit, hold down costs and increase revenue.
Increasing revenue is easy. Since the same "government" that runs the health care monopoly is the one that can raise taxes, just raise taxes and designate a portion of those taxes (less government employee salaries, kickbacks, bribes, and other related costs) to fund the health care monopoly. (For the sake of this argument, we'll assume that you went to an Ivy League business school where your professors didn't teach the Laffer Curve, the Austrian School of Economics, free-market capitalism, von Mises, Hayek, or Friedman. Plus, you work in an Administration that eschews such economic drivel, preferring to pursue an Agenda, and economics be damned.)
So. If you were going to hold down costs related to health care, you'd look at two places - the health care providers and the health care recipients. Now in an actual competitive business environment, you can't consider the health care recipients as a "cost", since they are the consumers - the source of revenue. But in a health care monopoly run by "government", health care recipients are a cost driver, not a revenue source. How do you lower costs associated with health care recipients? Easy: You want them to be healthy; you don't want them using the health care services. In a health care monopoly, how do you accomplish that? Two potential ways.
1) Raise the price of items, services, and activities that you deem "health-averse". Or mandate against (i.e. ban) items, services, and activities that you deem "health-averse". This would be anything from fast food (too fattening, leads to obesity, increasing the need for health care) to motorcycles (too dangerous, no seatbelts, higher incidence of accidents, increasing the need for health care) Since the health care monopoly is run by the same "government" that can pass laws banning such items (or heavily taxing "health-averse" items, services, and activities, making them so expensive as to essentially remove the consumer market for same), this course of action should be of primary importance. All you need to do is make a list of characteristics exhibited by habitual health-care users, then make a list of items, services, and activities that contribute (in one form or other) to said characteristics. Ban or heavily tax such items. Which leads to the second way to lower costs related to health care recipients...
2) Note that elderly adults are disproportionately disposed to need health care, and at a typically higher-level (read: more costly) version of health care than their less-senior counterparts. Ergo, advanced aging is bad, and should be discouraged. Since outright murder of elderly citizens is not politically efficient, in practical terms "discouraging aging" means withholding (or making so costly as to effectively prevent the use of) health care for certain "high-risk" health care recipients, the elderly being among those considered "high-risk". Also, diabetics, AIDS patients, and preemie (the so-called "Million Dollar") babies.
To summarize: a health care monopoly run by "government" is one predisposed to pick winners and losers (those who can receive a modicum of health care, and those who cannot, respectively). Winners being young, healthy, wealthy, and/or risk-averse citizens. Losers being elderly, chronically ill, low-to-moderate income, and/or thrill-seeking citizens.
A modest proposal? A brave new world? No. Look no further than the first paragraph of this AP article:
Smoking takes years off your life and adds dollars to the cost of health care. Yet nonsmokers cost society money, too -- by living longer.
Not such a funny story is it?
UPDATE:
Heh. Hannity and British MEP Daniel Hannan discuss the topic. The Brit knows whereof he speaks.
Tuesday, February 17, 2009
BANK-ruptcy
When it comes to businesses going down the tubes, I am not in favor of nationalization of businesses, or industries. I am in favor of creative destruction. This post gives a different spin to the debate on nationalization - the author suggests calling it a bankruptcy, because that's what it is - as long as the government is not involved in running the newly reorganized firm. For the life of me, I can't find much to criticize about his points. Read it and see what you think.
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